TAMARA JEAN WALLS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

TAMARA

Middle

JEAN

Last Name

WALLS

Suffix

Business Name

TAMARA JEAN WALLS MD

Original Issue Date

03/16/2004

Effective Date

04/05/2023

Expiration Date

07/31/2026

City

GLEN CARBON

State

Zip

62034

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023